When it comes to voting issues, proponents say it should be pretty simple: make sure the bulk of dental insurance premium costs end up in patients’ mouths.
Opponents argue the measure, a 21-13 voting matter, would increase premium costs, reduce consumer choice and block access to dental insurance for the state’s most vulnerable residents, especially children. .
The question, whether the signatures presented to the Secretary of State Guillaume Galvin on July 6 are certified, would ask voters to approve a measure that would require dental insurers to spend at least 83% of insurance premiums on patient care, and if the money is not spent, coverage would be refunded to subscribers .
In Massachusetts, 88% of medical health insurance premiums must be used for treatment, otherwise the money is returned to the policyholder as a refund. This is called an annual overall medical loss ratio.
Extending it to dental insurance just makes sense, say supporters of the ballot question.
Both sides had it in the shadow of the State House on July 6 when they made their case at a midday rally.
Diane Morada lobbyist working with the Balloting Matters Committee, told the press conference that some large dental insurance companies spend up to 40% of what they collect in premiums on “executive salaries, bonuses and other administrative expenses” rather than patient care.
“A yes vote would help fix a broken system in which insurance companies benefit from denying claims and limiting coverage,” Morad said.
State Senator Harriet ChandlerD-worcesterproposed a bill that echoes what could be included in the ballot question.
Dental health is essential to overall health, according to the Massachusetts Dental Society.
“Oral health plays a very important role in overall health,” with many systemic diseases indicated by oral health symptoms, according to the organization.
Plaque, gum disease, missing teeth all contribute to other conditions, including lung problems, heart disease and stroke.
Pregnant women with gum disease are more likely to give birth prematurely, according to the Massachusetts Dental Society. And low birth weight babies are more likely to have breathing problems, anemia, jaundice (yellowing of the skin due to liver problems), developmental delays and even congestive heart failure. . Teeth and gum problems can indicate diabetes and osteoporosis, a condition that affects some 10 million Americans, including 8 million women.
The Massachusetts Dental Society Board of Directors approved the ballot issue.
“As an advocate for dental care for all Massachusetts residents, the (Massachusetts Dental Society) endorses the Massachusetts Medical Loss Ratios initiative for dental insurance plans and encourages Massachusetts residents to take it in November,” said Dr. Meredith Bailey, the president of the association. “Patient dollars should be compulsorily spent to support their oral health, and patients deserve to see how much of their dental insurance premiums pay for care as opposed to administrative costs.”
The measure would require dental insurers to disclose the projected medical loss ratio for their plans. It would also force them to anticipate base rates and file those fees by July. The measure would put the approval of base rates in the hands of the state Insurance Division.
The Access Protection Committee to Quality Dental Care – a coalition of dental plans, health plans, life insurers and professional associations organized against the ballot issue – said it was concerned the measure would increase the costs of health care for consumers and small businesses.
“Supporters of this election issue are not being candid with voters,” the committee said. “What they don’t tell you is that their anti-consumer proposal will increase costs for Massachusetts families and employers – an almost 40% increase in premiums in a recent study – and may result in thousands of residents being denied access to much-needed dental care.”
A study commissioned by National Association of Dental Plans examination of the costs and benefits of the proposal revealed that most Massachusetts dental insurers allocate between 60% and 79% of premiums to patient care, depending on company size, with smaller companies allocating fewer dollars while larger companies allocating more.
The rest of the premiums billed are used, in part, for administrative costs.
The study, by Millimman Research, the group found that the proposal would affect companies with a smaller pool of customers. Additionally, meeting the 83% mandate, coupled with the cost of rebates, would tax the company’s revenue.
Opponents argue that a yes vote on the ballot issue in November could drive some dental insurance providers out of Massachusetts.
“With consumer prices reaching all-time highs, the Commonwealth does not need this additional regulation which will only increase costs and reduce patient choice statewide,” a committee statement said. of opposition.
The study predicts that premiums could increase by 38%, from $35 per month to $50.
State House Press Service contributed to this report.